Repair of Access-Related Femoral Artery Pseudoaneurysms Using Percutaneous Suture-Mediated Closure With...

Femoral artery pseudoaneurysms (PSAs) are a complication of endovascular access procedures that typically require repair. Patients with contraindications or failed attempts at traditional repair methods or those who are unfit for open surgery may benefit from an alternative, minimally invasive and durable approach. We describe our procedural technique and experience using the Abbott Perclose ProStyle percutaneous suture-mediated closure repair (PSMCR) device with ultrasound-only guidance to treat noninfectious postprocedural femoral PSAs (n = 5) with appropriately sized arteriotomy diameters. Our technique uses longitudinal-axis ultrasound imaging to guide real-time access through the PSA neck for deployment of the PSMCR device. PSMCR was successful in 3 of 5 patients; 2 required alternative repairs. Failures resulted from inability to access the PSA neck or ineffective suture closure. In select patients, ultrasound-guided PSMCR is a radiation-free alternative that should be considered in the management algorithm for common femoral artery PSAs, particularly in patients considered too high risk for open repair.